Visuomotor Rehabilitation Training for Manual Task Deficits From Macular Scotomas (VRT)
|ClinicalTrials.gov Identifier: NCT01691027|
Recruitment Status : Completed
First Posted : September 24, 2012
Results First Posted : February 23, 2018
Last Update Posted : February 23, 2018
|Condition or disease||Intervention/treatment||Phase|
|Scotoma, Central Central Visual Impairment||Behavioral: Visuo-motor training||Not Applicable|
The research objective is to test the hypothesis that practicing eye-hand coordination using tablet-computers can improve manual skills of those with Age-related Macular Degeneration (AMD). AMD causes the loss of sharp central vision used for reading and many other everyday activities. Those with AMD experience a "macular scotoma", a blanked-out area of whatever they're attempting to look at, and they must use an area of peripheral vision, the "Preferred Retinal Locus (PRL)" to look at objects of interest. The PRL does not provide sharp vision, causing deficits in eye-hand coordination needed for manual tasks. There have been few studies of visuo-motor rehabilitation training for deficits caused by macular scotomas. However, a recent study demonstrated that visuo-motor eye movement training dramatically improved reading ability of subjects with AMD. In addition, it has been shown that playing action video games can improve certain visual skills. Thus, a small but growing body of research suggests that it may be possible to ameliorate manual task deficits caused by AMD through computer-based visuo-motor rehabilitation training.
To test this idea, two visuo-motor training modules will be developed for low-cost tablet computers that subjects will use at home. Modules will be for, line and circle tracing, and video games. Both modules will involve PRL-hand coordination by moving a stylus on the tablet screen in response to stimuli. Line and circle tracing will develop eye-hand coordination skills needed for printing. The video game module will provide practice in PRL-hand coordination. Progress in PRL-hand coordination will be automatically recorded on the tablet-computer.
Changes in manual task performance from the training modules will be assessed after each training module using previously developed Scanning Laser Ophthalmoscope (SLO) tests of maze-tracing, and printing. The SLO will also be used to determine the position and fixation stability of the subject's PRL and the retinal position of the scotoma. SLO testing will be repeated three months after all training. Digitized SLO video images showing the hand, stylus, and object on the retina will be measured and analyzed. Several performance measures will be derived from the SLO image analysis including maze-tracing accuracy, printing legibility, retinal area of the stylus, percentage of time the stylus is in the scotoma, and PRL retinal area. This data will be statistically analyzed to determine whether visuo-motor training with the computer tablets improves manual task performance and whether one module is more effective than other.
There will be six groups of five subjects. Subjects will be assigned as they are recruited to a group until the group is full. Two groups will have training delayed by 6 months and will be tested on the SLO 4 times to assess changes in the dependent measure without training. Following training on each module, subject will be tested on maze tracing and printing in the SLO. Two groups undergo four SLO tests without training and begin training six months later.
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||4 participants|
|Intervention Model:||Single Group Assignment|
|Intervention Model Description:||All eligible subjects trained on three computer-based training modules. SLO assessment of changes in fine manual task performance and in retinal functional geography was done before and after each training module.|
|Masking:||None (Open Label)|
|Official Title:||Visuomotor Rehabilitation Training for Manual Task Deficits From Macular Scotomas|
|Study Start Date :||July 2013|
|Actual Primary Completion Date :||July 2015|
|Actual Study Completion Date :||December 2015|
Experimental: Visuo-motor training for low vision
All participants undergo training on scotoma awareness, Line and Circle Tracing and Video games
Behavioral: Visuo-motor training
Participants will undergo training on three developed software modules on Samsung Galaxy Note Pro tablets to see their effect on low vision rehabilitation
- Improvement in Eye-hand Coordination [ Time Frame: base line, pre-test, post tracing and videogames training ]Maze tracing represents the fine eye-hand coordination needed for a wide variety of manual tasks and an improvement in maze tracing indicates an improvement in eye-hand coordination
- Stylus to Eclipse Area [ Time Frame: Base line, Pre and Post training (approximately 3 months) ]
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01691027
|United States, Missouri|
|Kansas City VA Medical Center, Kansas City, MO|
|Kansas City, Missouri, United States, 64128|
|Principal Investigator:||George T Timberlake, PhD||Kansas City VA Medical Center, Kansas City, MO|